Registration

General Registration Information - All Registrants

* Create a Login Name:
* Login Password:
* Retype Password:
* Individual Type - Robotics (Custom Field) Adult Mentor
Student
Team Captain
Alumni
Parent
Prefix:
* First Name:
* Last Name:
* Street Address:
* City:
* State:
* Zip Code: -
* Your Email:
Your Secondary Email:
* Your Phone:
Your Secondary Phone:
* Parent's Email (If you are a parent, repeat your email here):
* Parent's Cell Phone (If you are a parent, repeat your cell phone here):
* T-Shirt Information:

Current Team Members Only - Students

Student Interests (Select all that apply) Robot Build
Robot Electrical
Robot Programming
Website Design
Robot Drive Team
Marketing (Companies)
Fundraising (Car-show, Pizza, etc.)
FLL/FTC Mentoring
Media
Scouting
Competion Awards
Social Event Planning
Other
Graduation Year
Special Dietary Needs/Allergies
Can you legally drive a car? Yes
No
Do you own a car? No
Yes
How many passengers can you carry?
Have you taken Research and Design?
Parent 1 First Name:
Parent 1 Last Name:
Parent 2 First Name:
Parent 2 Last Name:
Parent Secondary Email:
Parent Secondary Cell Phone:

Adults Only - Parents, Mentors, Alumni

Would you be interested in mentoring (Select all that apply)? Robot Build
Robot Electrical
Robot Programming
Website Design
Robot Drive Team
Marketing/Sponsorships (e.g., to companies)
Fundraising (e.g., car show, pizza)
FLL/FTC Mentoring
Media
Scouting
Competition Awards
Social Event Planning
Team Supervision (e.g., during team meetings)
Other
Please elaborate: preferred days of the week, times, areas of expertise, etc.
Are you willing to bring a meal during the build season? Yes
No